431 Elliott Ave - BR18-004234 - REROOFSRA R00fiNq, LLC
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t, Ull: 407-212-8199
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City of Sanford
Building and Fire Prevention
Product Approval Specification Form
Permit #
Project Location Address M/ Soq76 A/z F/--34-7-7 /
As required by Florida Statute 553.842 and Florida Administrative Code 9N-3, please provide the
information and product approval number(s) on the building components listed below if they are to be
utilized on the construction project for which you are applying for a building permit. We recommend that
you contact your local product supplier should you not know the product approval number for any of the
applicable listed products. Be aware that windows, skylights, and exterior doors must be tested in
accordance with the Florida Building Code, Section 1714.5. More information about Statewide Product
Approval can be obtained at
The following information must be available on the jobsite for inspections:
1. This entire product approval form
2. A copy of the manufacturer's installation details and requirements for each product.
Category / Subcategory Manufacturer Product
Description
Florida Approval #
include decimal
1. Exterior Doors
Swinging
Sliding
Sectional
Roll U
Automatic
Other
2. Windows
Single Hun
Horizontal Slider
Casement
Double Hun
Fixed
Awning
Pass Through
Projected
Mullions
Wind Breaker
Dual Action
Other
June 2014
Category / Subcategory Manufacturer Product
Description(including
Florida Approval #
decimal
3. Panel Walls
Siding
Soffits
Storefronts
Curtain Walls
Wall Louver
Glass block
Membrane
Greenhouse
E.P.S Composite
Panels
Other
4. Roofing Products
Asphalt Shingles G1rr) j
Underla ments p
Roofing Fasteners
Nonstructural
Metal Roofing
Wood Shakes and
Shingles
Roofing tiles
Roofing
Insulation
Waterproofing
Built up roofing
System
Modified Bitumen
Single Ply Roof
Systems
Roofing slate
Cements/
Adhesives /
Coating
Liquid Applied
Roofing Systems
Roof Tile
adhesive
Spray Applied
Polyurethane
Roofing
E.P.S. Roof
Panels.
Roof Vents
Other
June 2014
Category / Subcategory Manufacturer Product
Description
Florida Approval #
include decimal
5. Shutters
Accordion
Bahama
Colonial
Roll up
Equipment
Other
6. Skylights
Skylights
Other
7. Structural
Components
Wood Connectors /
Anchors
Truss Plates
Engineered Lumber
Railing
Coolers/Freezers
Concrete Admixtures
Precast Lintels
Insulation Forms
Plastics
Deck / Roof
Wall
Prefab Sheds
Other
8. New Exterior
Envelope Products
Applicant's Signature
Applicant's Name
Please Print)
SfA I" ilerr
June 2014
iicial Records Inquiry Page I o
NOTICE OF COMMENCEMENT
Results that meet criteria Instrument Details
Show LegalColumnsI Export to Excel j 5944823 CT Ita3mm
column here or select columns 018113238
9222 1965 Fro_ rrti
ai 2
of 2 records A
uFile #
2018113238
Book /
Page 9222 /
1965 Type
6. LENDER:Name: Address:
NOTICE
COMM'' r
7.
Persons within the State of Florida Designated by Owner upon whom notice orF 713.
13(1)(a)7., Florida Statutes. ,,,,, File
Date mll Name, Address:
10/
4/2018 8:25:14 AM S. In addition, Owner designates to
receive a copy of the Lienofs Notice as provided in Section 713.13(1)(b), Florida E Number
of Pages 1 g. Expiration Date of Notice of Commencement (The expiration is 1 year from date of reOrigini
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE E Description
S40
L46 ALL L47 FORT MELLON 7 Permit
Number. Parcel
10 Number. 30-19-31-525-0000-0470 The
undersigned hereby gives notice that improvement will be made to certain real prop following
Information is provided iTnythis LNoticeaofCoofmprmeonfcemelnptyetttraI. 0ES4ln$ QOP1RR& +BALL Lot 147 07iiM011011 pl'C 3y Ciddr add. Document Status
From Parties:
SIRICA ANTHONY
SIRICA TONY
To Parties:
RE NOTICE
OF COMMENCEMENT Related Instruments
2018113238 9222/
1965( 2. GENERAL
DESCRIPTION OF IMPROVEMENT: R'Raof ,.
3. OWNER
INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRAC' Nerrie and
address: Anthonci Sirica 431 ELLIOTT AVE SANFORD. FL 3 owner listed
above) Name: 4. CONTRACTOR:
Name Address: 105
Tral e ( 5. SURETY
Of applicable, a CONSIDERED IMPROPER
PAYMENTS UNDER CHAPTER 713, PART I, SECTION PAYING TWICE
FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF CQMI JOB SITE
BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FlNAN BEFORE COMMENCING
WORK OR RECORDING YOUR NOTICE OF COMMENCEMF SI o!
ra or Lessea'e wized ORcerANrxbdParinedManaaer)
State of
1` 1f l Countyof The foregoing
instrument was ac`kn owlopdgedbefore me this by 'l
y I `1:.01 Noma of
Person matlrg staemant who has
produced entlflcatlon type of Identification produced: I0) SE
JENNIFERM.GOILOWAYNotary PublicSlalo ofFloridaCommiionxGG
162235 Y'My
Comm. Expires Nov 21, 2021 ps://recording.
seminoleclerk.org/DuProcessWeblnquiry 10/ 11 /20
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: W )
I hereby name and appoint: ^_ elS A
an agent of 51q14 Rm7z /% & 6
of Company)
to be my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all things
necessary to this appointment for (check only one option):
91 for work located at:
94reet Address)
Expiration Date for This Limited Power of Attorney:
License Holder Name: , & # f//P/y
State License Number:
Signature of License H
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged before me this i day Q f Dc v bc.r',
200 1 $ , by S Cps' R ffe who is ersonally known
to me or who has produced
identification and who did ( take an oath.
gnature
Notary Seal) 4- l A-. M061 1 i N
Print or type name
Notary Public - State of Fid(z 1 O—
Commission No. FFI $ 91
My Commission Expires: Gj l
MY COMMISSION 1183914 rEXPIRES:
January 9, 2019 Rev.
08.12) d p'"yR. Bonded Thou Notary Public Underwriters as
SA'NFORD Building & Fire Prevention Division
RESIDENTIAL REROOF POLICY & PROCEDURES
4' l
PERMITTING REQUIREMENTS - NO PLAN REVIEW REQUIRED
THIS DOCUMENT (SIGNED) ALONG WITH AN ACCURATE AND COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK ARE
REQUIRED TO BE SUBMITTED AS PART OF YOUR PERMIT APPLICATION.
THE SCOPE OF WORK MUST INCLUDE ALL APPLICABLE FLORIDA PRODUCT APPROVAL NUMBERS FOR ALL ROOF
COMPONENTS THAT WILL BE INSTALLED ON THE PROJECT.
A PERMIT WILL NOT BE ISSUED WITHOUT THESE DOCUMENTS. COPIES WILL BE MADE TO POST ON THE JOB SITE.
PROJECTS LOCATED IN THE SANFORD HISTORIC DISTRICT WILL REQUIRE PLAN REVIEW AND APPROVAL BY THE
SANFORD HISTORIC PRESERVATION BOARD
INSPECTION POLICY & PROCEDURES
A FINAL ROOF INSPECTION IS THE ONLY INSPECTION REQUIRED FOR RESIDENTIAL (SINGLE FAMILY, TOWNHOUSE,
MOBILE HOME, APARTMENT AND/OR CONDOMINIUM) RE -ROOF PERMITS.
THE FOLLOWING IS REQUIRED TO BE PROVIDE ON THE JOB SITE:
PERMIT CARD, POSTED IN A CONSPICUOUS AND WEATHERPROOF LOCATION
COMPLETED RESIDENTIAL RE -ROOF SCOPE OF WORK
COMPLETED AND NOTARIZED INSPECTION AFFIDAVIT
ALL FLORIDA PRODUCT APPROVAL AND CORRESPONDING INSTALLATION INSTRUCTIONS
PRODUCT APPROVAL SHALL MATCH WHAT IS ON THE SCOPE OF WORK)
DIGITAL PHOTOGRAPHS (MUST INCLUDE THE PERMIT NUMBER OR ADDRESS IN EACH PICTURE)
o EACH PLANE OF THE ROOF, SHOWING THE UNDERLAYMENT INSTALLED
O ROOF DECK NAILING PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER)
o ROOF DECK NAILS USED (INCLUDING A MEASURING DEVICE OR RULER SHOWING SIZE OF NAILS)
o UNDERLAYMENT PATTERN & SPACING (INCLUDING A MEASURING DEVICE OR RULER)
O DRIP EDGE & VALLEY ATTACHMENT (INCLUDING A MEASURING DEVICE OR RULER)
o SHINGLES INSTALLED, NAIL PATTERN AND LOCATION OF NAILS
SKYLIGHTS (IF APPLICABLE)
o DIGITAL PHOTOGRAPHS SHOWING ALL INSTALLATION COMPONENTS, PER FL PRODUCT APPROVAL
o DIGITAL PHOTOGRAPHS SHOWING ALL REQUIRED FLASHING, PER FL PRODUCT APPROVAL
FAILURE TO FOLLOW THESE SPECIFIC GUIDELINES WILL RESULT IN AN AFFIDAVIT PROVIDED BY A FLORIDA DESIGN
PROFESSIONAL (ARCHITECT OR ENGINEER), CERTIFYING FBC CODE COMPLIANCE BY PERSONAL INSPECTION.
CONTRACTOR (OR OWNER/BUILDER) SIGNATURE: DATE: ` 6
D, SA'' NFO PERMIT #
Building & Fire Prevention Division
RESIDENTIAL RE -ROOF SCOPE OF WORK
4yJOBADDRESS: v V'jjl' / /
STRUCTURE TYPE: XvSINGLE FAMILY RESIDENCE/TOWNHOUSE O MOBILE HOME O APARTMENT/CONDOMINIUM
RE -ROOF TYPE:9 PLACEMENT (TEAR OFF EXISTING ROOF AND REPLACE WITH NEW COMPONENTS)
RE-COVER (NEW ROOF INSTALLED OVER EXISTING ROOF
DECK TYPE (PLEASE SPECIFY: f/K-I
PLEASE NOTE: ONLY O SQUARE FEET OF THE
ROOF VENTILA O OFF -RIDGE O RIDGE
DECK IS PERMITTED TO BE REPLACED * *
SOFFIT OPOWEREDVENT OTURBINES IC_r`av Iv'-
SKYLIGHTS: O YES NO IF YES, PLEASE PROVIDE FLORIDA PRODUCT APPROVAL #: -YQQ)
V%vj CCH-csn
MAIN ROOF AREA
ROOF SLOPE: O LESS THAN 2:12 2:12 - 4:12 O 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
O SHINGLE FL#
OMETAL FL#
DIFIED BUMENIT I Q M ' FL# 1 /
O TORCH DOWN FL#
O INSULATED FL#
O TILE FL#
O OTHER: FL#
ROOF EXTENSIONS PORCHES PATIOS ETC. **IFAPPLICABLE**
ROOF SLOPE: LESS THAN 2:12 O 2:12 - 4:12 O 4:12 OR GREATER
TYPE OF ROOF MANUFACTURER FLORIDA PRODUCT APPROVAL
O SHINGLE FL#
O METAL FL#
MODIFIED BITUMEN FL# of 3 3 l
p TORCH DOWN FL#
OINSULATED FL#
O TILE FL#
O OTHER: FL#
t SANFOREr Building & Fire Prevention Division
RESIDENTIAL RE -ROOF AFFIDA VIT
RESIDENTIAL RE -ROOF INSPECTION AFFIDAVIT
NAILING, SHEATHING, DRY -IN, FLASHING, AND ALL FINAL ROOF COVERINGS
PERMIT #: ADDRESS: z AIP4 aite
Cl,iol l 7.7
I Sellle `j AS A(N) GENERAL, BUILDING, RESIDENTIAL, OR
ROOFING CONTRACTOR, ENGINEER, ARCHITECT, OF F.S. CHAPTER 468 BUILDING INSPECTOR, I HEREBY AFFIRM, THAT ALL OF THE
FOREGOING INFORMATION IS TRUE AND ACCURATE AND THAT ALL ROOFING COMPONENTS LISTED ON THE SCOPE OF WORK AT THE
ABOVE REFERENCED ADDRESS HAVE BEEN INSTALLED IN ACCORDANCE WITH THEIR PRODUCT APPROVALS AND ALL APPLICABLE CODE
REQUIREMENTS - SPECIFICALLY FLORIDA BUILDING CODE, EXISTING BUILDING. IN ADDITION I CERTIFY THE INSTALLATION MEETS ALL
REQUIREMENTS FOR SECONDARY WATER BARRIER AND NAILING OF THE ROOF DECK, IN ACCORDANCE WITH THE HURRICANE RETROFIT
MANUAL REQUIRE ENTS (BASED ON F.S. CHAPTER 553.844).
LICENSE #: 133) 3
COMPANY / CONTRACTOR:
CONTRACTOR SIGNATURE:
MUST BE SIGNED BY LICENSE HOLDER OR OWNER/BUILDER)
DATE:
A FINAL ROOF INSPECTION IS REQUIRED:
THIS SIGNED AND NOTARIZED AFFIDAVIT MUST BE PROVIDED AT THE JOB SITE AT THE TIME OF THE FINAL ROOF INSPECTION,
ALONG WITH DIGITAL PHOTOGRAPHS OF EACH PLANE OF THE ROOF SHOWING IN DETAIL ALL COMPONENTS (DECKING,
UNDERLAYMENT, FLASHING, DRIP EDGE ATTACHMENT) WITH THE PERMIT NUMBEROR ADDRESS CLEARLY MARKED ON THE DECK
FOR EACH INSPECTION. THE PHOTOGRAPHS MUST INCLUDE A RULER OR MEASURING DEVICE TO CONFIRM ALL NAIL SPACING AND
OVERLAPS, INCLUDING DRIP EDGE AND VALLEY FLASHING. PLEASE REFER TO THE RE -ROOF POLICY AND INSPECTION PROCEDURE
PAPERWORK FOR FURTHER EXPLANATION OF ALL REQUIREMENTS.
FAILURE TO FOLLOW ALL REQUIREMENTS WILL RESULT IN A FAILED INSPECTION, A RE -INSPECTION FEE AS
WELL AS REQUIRING A DESIGN PROFESSIONAL (ARCHITECT OR ENGINEER) TO CERTIFY, BASED ON PERSONAL
INSPECTION, THE INSTALLATION OF ALL ROOFING COMPONENTS.
STATE OF FLORIDA COUNTY OF C eM-
Sworn to and Subscribed before me this day of &.K 20 /8 by:
Ile N Who is klersonally Known to me or has Produced (type of
tification) as identification.
gnature of Notary Public
State of Florida
r—adlAh A 1U061' l/j A)
Print/Type/Stamp Name
of Notary Public